This invention relates generally to surgical methods and apparatus. More particularly, this invention pertains to methods and apparatus for laparoscopic endosurgical retraction.
Traditional endosurgery in the chest or abdominal cavity is performed by large instruments through large incisions. Organs and vessels, e.g. intestines or bowels, must often be pulled or pushed aside to provide access to the particular target area of surgery. Conventionally, large retractors and retraction clamps are used for holding the interfering organ or vessel out of the way during the surgical operations; such procedures require large incisions with accompanying intense trauma.
In recently developed laparoscopic surgery, one or more small sealable ports or trocars are established through the body cavity wall. These ports may vary in diameter, typical port sizes being about 5 and 11 mm in diameter. Standard retractors are too large to be inserted through laparoscopic ports, so special miniature instruments must be used. All of the instruments are used through the sealable laparoscopic ports. Thus, the miniature laparoscopic instruments have handles which project from the port for external manipulation. The port is designed to seal against excessive loss of insufflation gas, the latter typically injected into the cavity to expand it.
Laparoscopic surgery offers great promise for reducing patient trauma, pain, hospitalization time, cosmetic disfigurement and expense typical of much of traditional full-scale laparotomy.
One of the limitations with laparoscopic surgical procedures has been the difficulty in moving interfering organs and vessels away from the surgical target area, and maintaining them in a non-interfering location. At present, rigid instruments passing through the laparoscopic port are used in some cases to retract the interfering organ. However, these instruments must often span a considerable distance across the cavity to pull or push the organ or vessel aside, making such manipulation difficult. In addition, these instruments themselves may converge in the operating area, crowding the target surgical area and increasing the difficulty of access. These instruments also monopolize laparoscopic ports which may more advantageously be used for passage of other surgical instruments. Furthermore, it may be necessary to increase the size of the surgical team to continuously maintain traction on the organ or vessel to maintain it in the desired displaced position during the surgical operation.
A method and apparatus are needed for better retraction and exposure during laparoscopic surgery within a body cavity, to enable precise positioning of organs or vessels, to reduce the operating time and the recovery period, to reduce the cost of surgery, and to expand the applicability of laparoscopic surgical techniques.